Anti-retroviral drugs induced Photosensitivity may be Two culprits in Mixed formulation, a case report and literature review

• Some anti-retroviral drugs potentially cause photosensitivity in HIV patients • Tenofovir disoproxil fumarate and efavirenz are the frequent culprits reported. • Phototesting remains the objective tool to provide a definite diagnosis of drug-induced photosensitivity and identify culprit radiation wavelengths. Although the most frequent presentation of adverse drug events amongst HIV- infected individuals is skin rash, photosensitivity is uncommon. We herein described an HIV-infected lady who presented with photo-distributed annular target-like eruptions and small tense blisters. Our patient had objectively reduced erythemal thresholds on broadband UV phototesting, to both UVA and UVB. Resolution of the abnormal responses on retesting undertaken after cessation of the tenofovir disoproxil fumarate and efavirenz in mixed formulation for five months confirmed a diagnosis of drug-induced photosensitivity. Given the preferred first-line anti-retroviral therapy which usually contains both TDF and EFV, photoprotection from broad-band ultraviolet wavelengths should be emphasized for the patients receiving this antiretroviral regimen.